How augmented reality could change the future of surgery | Nadine Hachach-Haram

翻译人员: Zikun Fu 校对人员: Kai Lu

According to the theories of human social development,

根据人类社会发展的理论，

we're now living through the fourth great epoch

我们目前正在经历着科技进展的

of technological advancement,

第四时期，

the Information Age.

信息时代

Connectivity through digital technology is a modern miracle.

由数字科技所提供的连接性是一个现代奇迹

We can say it has broken down barriers of time and space which separate people,

这种连接打破了人们之间的时间与空间屏障，

and it's created a condition for an age

并且创造了一个

where information, ideas can be shared freely.

可以自由分享信息和想法的时代

But are these great accomplishments in digital technology

但是数字科技带来的伟大成就

really the endgame in terms of what can be achieved?

真的就仅此而已了吗？

I don't think so,

我并不这么认为，

and today I'd like to share with you

今天我想跟大家分享一下

how I believe digital technology can take us to even greater heights.

我对数字科技未来新高度的展望

I'm a surgeon by profession,

我是一名外科医生，

and as I stand here today talking to all of you,

在我站在这里跟你们讲话的同时，

five billion people around the world lack access to safe surgical care.

全球各地有五十亿的人缺少安全的手术护理

Five billion people.

五十亿人

That's 70 percent of the world's population,

占了有全球70%的人口，

who according to the WHO's Lancet Commission

根据世界卫生组织“柳叶刀委员会”的标准，

can't even access simple surgical procedures

他们甚至连最基本的外科手术

as and when they need them.

都进行不了

Let's zoom in on Sierra Leone,

让我们看看塞拉利昂，

a country of six million people,

这是一个六百万人口的国家，

where a recent study showed that there are only 10 qualified surgeons.

一项近期的研究指出那里只有十名合格的外科医生

That's one surgeon for every 600,000 people.

那就是六十万人民指望着一名医生

The numbers are staggering,

数字很惊人，

and we don't even need to look that far.

我们甚至不用看得那么远

If we look around us here in the US,

如果我们关注一下美国，

a recent study reported that we need an extra 100,000 surgeons by 2030

一项研究报告说在2030年前 我们需要额外的十万名外科医生

to just keep up with the demand for routine surgical procedures.

仅仅来应对日常的外科手术需求

At the rate that we're going, we won't be meeting those numbers.

而依照我们现在的发展速度 这十万是达不到的

As a surgeon, this is a global issue that bothers me.

作为一名外科医生 这个全球性的问题很是困扰着我

It bothers me a lot,

使我心烦意躁，

because I've seen firsthand

因为我亲身经历过，

how lack of access to safe and affordable healthcare

如果接收不到安全的承担得起的护理

can blight the lives of ordinary people.

老百姓的生活将会深深的受到伤害

If you're a patient that needs an operation

如果你是一名急需进行手术的患者

and there isn't a surgeon available,

可是当时并没有空闲的外科医生，

you're left with some really difficult choices:

你只有这几项艰难选择：

to wait, to travel,

等待，另寻他路，

or not to have an operation at all.

或者放弃治疗

So what's the answer?

所以，怎么解决呢？

Well, part of you are carrying some of that solution with you today:

其实，今日在座的各位就携带着一部分：

a smartphone, a tablet, a computer.

一部智能手机，一个平板电脑或者一台电脑

Because for me,

因为对我而言，

digital communications technology has the power to do so much more

数字通信技术拥有更强大的威力

than just to allow us to shop online,

不仅仅能让我们网络购物，

to connect through social media platforms and to stay up to date.

与朋友们在社交媒体中聊天，跟上潮流

It has the power to help us solve some of the key issues that we face,

它还可以解决我们面临的一些关键问题，

like lack of access to vital surgical services.

比如难以接受到关键手术

And today I'd like to share with you

今天我想跟大家分享一下

an example of how I think we can make that possible.

我对如何实现这个问题的想法

The history of surgery is filled with breakthroughs

手术的历史充满着科学和技术上的突破，

in how science and technology was able to help the surgeons of the day

这些突破帮助如今的外科医生，

face their greatest challenges.

面临严峻的挑战

If we go back several hundred years,

我们如果回到几百年前，

an understanding of microbiology

当时微生物学的发现

led to the development of antiseptic techniques,

带来了杀菌技术的发展，

which played a big role in making sure

这项技术大大提高了

patients were able to stay alive postsurgery.

病人术后的存活率

Fast-forward a few hundred years

往后快进个几百年，

and we developed keyhole or arthroscopic surgery,

我们发明了“微创”手术 也就是关节镜手术，

which combines video technology and precision instruments

这种技术结合了视频技术和高精密仪器

to make surgery less invasive.

减少了手术产生的创伤

And more recently, a lot of you will be aware of robotic surgery,

就在不远的将来 机器人手术将来到我们身边，

and what robotics brings to surgery is much like modern automated machinery,

而这种技术就像现代的机械技术一样，

ultraprecision,

超级精密，

the ability to carry out procedures at the tiniest scales

它可以在最细小的程度上进行手术

with a degree of accuracy that even surpasses the human hand.

如此程度甚至超过了人手的精度

But robotic surgery also introduced something else to surgery:

机器人手术还给手术带来一种新的想法：

the idea that a surgeon

一名外科医生，

doesn't actually have to be standing at the patient's bedside to deliver care,

并不需要亲身站在患者面前进行手术

that he could be looking at a screen

他可以看着屏幕

and instructing a robot through a computer.

使用电脑操控着机器人，

We call this remote surgery.

我们称之为“远距外科”

It is incumbent on us

我们有义务，

to find solutions that solve these answers in a cost-effective and scalable way,

用合算的，可发展的方式解决这些问题，

so that everyone, no matter where they are in the world,

实现无论何时何地，

can have these problems addressed.

大家都可以得到帮助

So what if I told you

如果我告诉你们

that you didn't really need a million-dollar robot

其实并不需要一个百万美元的机器人

to provide remote surgery?

来进行远距手术

That all you needed was a phone, a tablet, or a computer,

你需要的全部 只是一部手机，一个平板电脑或者一台电脑，

an internet connection,

连接上互联网，

a confident colleague on the ground

还有一名有信心的外科医生在线，

and one magic ingredient:

再加上一点点魔法：

an augmented reality collaboration software.

一个增强现实协同软件

Using this augmented reality collaboration software,

使用这部软件，

an expert surgeon can now virtually transport himself

一名专业的外科医生可以虚拟的“传输”他自己

into any clinical setting

到任何一家诊所

simply by using his phone or tablet or computer,

仅仅通过他的手机，平板或者电脑，

and he can visually and practically interact in an operation

虚拟的进行一场手术

from start to finish,

从头至尾，

guiding and mentoring a local doctor through the procedure step by step.

引导着现场医生一步步地进行手术

Well, enough of me telling you about it.

好啦，我说的已经够多的了

I'd now like to show you.

我想给你们展示一下

We're now going to go live to Dr. Marc Tompkins,

我将直播一场由Marc Tompkins大夫，

an orthopedic surgeon at the University of Minnesota.

一名明尼苏达大学的矫形外科医师，

He's going to perform an arthroscopic surgery for us,

主刀的关节镜手术，

a keyhole surgery of the knee,

也就是对于膝盖骨的微创手术

and I'd like to disclose

我想声明一下，

that this patient has consented to having their operation streamed.

这名患者已经准许我们直播这场手术了

I'd also like to point out that in the interest of time,

另外由于时间关系，

we're just going to go through the first steps,

我们只会观看最开始的部分，

marking up the patient

也就是诊断一下患者，

and just identifying a few key anatomical landmarks.

识别出几处关键的解剖标志

Hello, Dr. Tompkins, can you hear me?

您好，Tompkins大夫，您听得见我吗？

Dr. Mark Tompkins: Good morning, Nadine.

早安，Nadine

Nadine Hachach-Haram: Everyone from TED says hello.

TED现场的观众请欢迎一下他

Audience: Hi.

Hi~

NHH: Alright, Dr. Tompkins, let's get started.

好的Tompkins大夫，让我们开始吧

So let's start with our incisions and where we're going to make these,

我们先从这些切口开始，

on either side of the patellar tendon.

它们的位置在膝盖肌腱的两侧，

So if you can make your incisions there and there,

如果你能在那里和那里开口，

that should hopefully get us into the knee.

就能很顺利地到达膝盖

MT: All right, I'm going in.

好的，我要开始了

NHH: Great.

好的

So we're just getting inside the joint now.

我们开始进入这些关节里面去了

So why don't we go around and have a quick look at the meniscus.

让我们来快速检查一下“半月板”，

MT: Perfect.

没问题

NHH: Great, so we can see there's a small tear there on the meniscus,

好的，我们可以看到半月板有一点小小的撕裂，

but otherwise it looks alright.

其他地方看上去没有问题

And if you turn and head to this direction,

如果你朝着这个方向，

follow my finger,

顺着我的手指，

let's have a quick look at the ACL and the PCL.

让我们快速检查一下交叉韧带

That's your ACL there, that looks quite healthy,

看到韧带了，挺健康的，

no problems there.

没有问题

So we've just identified that small meniscus tear there,

所以我们发现只是“半月板”有一点点撕裂，

but otherwise the fluid around the joint looks OK as well.

其他地方，以及关节旁边的液体都看上去没有问题

All right, thank you very much, Dr. Tompkins. Thank you for your time.

好的，Tompkins大夫 十分感谢您的时间

I'll let you continue.

我就不打扰您了，请继续

Have a good day. Bye.

好运，拜拜

(Applause)

（掌声）

So I hope through this simple demonstration

我希望通过这一场小小的演示

I was able to illustrate to you just how powerful this technology can be.

可以给你们展现一下这项技术的强大之处

And I'd like to point out that I wasn't using any special equipment,

而且我还想指出我并没有使用任何特殊的设备，

just my laptop and a really simple webcam.

只有我的笔记本电脑和一个普通的摄像头

We're so used to using digital technology

我们都非常习惯使用数字科技

to communicate through voice and text and video,

来进行语音，文字，视频沟通，

but augmented reality can do something so much deeper.

而增强现实可以做到更多更深

It allows two people to virtually interact

它可以让两个人进行虚拟互动，

in a way that mimics how they would collaborate in person.

就像他们是在方面合作一样

Being able to show someone what you want to do,

能够向一个人

to illustrate and demonstrate and gesture,

通过说明、演示和手势来传达你的想法，

is so much more powerful than just telling them.

比仅仅通过语音强大很多

And it can make for such a great learning tool,

而且这项技术还可以制造很棒的学习工具，

because we learn better through direct experience.

因为我们在亲身经历中可以更好的学习

So how is this making a difference around the world?

所以，它如何改变全世界呢？

Well, back in my teaching hospital,

在我的教学医院中，

we've been using this to support local district general hospitals

我们已经开始运用这项技术对一些本地的医院

and providing skin cancer surgery and trauma treatment.

提供皮肤癌手术和创伤治疗的帮助

Now, patients can access care at a local level.

现在病人只要在当地就可以接受治疗，

This reduces their travel time, improves their access,

这减少了他们的交通时间，增加了更多渠道，

and saves money.

还很省钱

We've even started seeing its use in wound care management with nurses

它甚至还可以帮助护士治疗病人伤口，

and in outpatient management.

以及对于门诊病人的管理

Most recently, and quite exciting,

就在最近，非常令人兴奋，

it was used in supporting a surgeon through a cancer removal of a kidney.

这项技术被用来帮助 一名外科医生移除一块癌变的肾脏，

And I'd like to just share with you a very quick video here.

我想给你们展示一下这个简短的视频

I apologize for some of the gruesome views.

抱歉，它可能包含一些可怕的图像

(Video) Doctor 1: OK. Show me again.

（视频）医生1: 好了，让我再看一下

Doctor 2: If you see here,

医生2: 你看这里

that's the upper part, the most outer part of your tumor.

这是上部，肿瘤的最外侧

Doctor 1: Yes.

医生1: 嗯

Doctor 2: So it's three centimeters deep,

医生2: 它有3厘米深，

so this should be three centimeters.

所以这个要调到3厘米

Doctor 1: Yes, yes.

医生1: 好的

Doctor 2: OK, so you need to get a 3.5 margin.

医生2: 所以你得切除3.5厘米才可以

Doctor 1: I'm going to show you anyway

医生1: 反正我都要给你看，

and tell me what you think about it.

跟我说一下你怎么看

NHH: We're also seeing the use of this technology at a global scale,

我们在全球都可以看到这项技术的运用，

and one of the most heartwarming stories I can recall

而我可以回想起其中最暖心的故事

is from the town of Trujillo in the north of Lima in Peru,

是源于秘鲁共和国，利马北部， 特鲁希略市中的一个小镇发生的，

where this technology was used to support the provision

这项技术被用作支持

of cleft lip and palate surgery to children,

一项对儿童施展的唇裂和腭裂手术，

children from poor backgrounds who didn't have access to health insurance.

这是一个来自贫穷家庭 没有健康保险的孩子

And in this town, there was a hospital with one surgeon

而这个小镇里的医院只有一名外科医生

working hard to provide this care,

努力地提供治疗，

Dr. Soraya.

Soraya大夫

Now, Dr. Soraya was struggling under the sheer demand

而Soraya大无法应对那么多

of her local population,

来自本地人民的需求，

as well as the fact that she wasn't specifically trained in this procedure.

并且她实际上并没有被专门培训过 如何进行这种手术

And so, with the help of a charity,

然后，通过基金会的帮助，

we were able to connect her with a cleft surgeon in California,

我们能够让她与一名加利福尼亚州的 唇腭裂外科医生取得联系，

and using this technology, he was able to guide her and her colleagues

通过这项技术 这名医生指导她和她的同事们

through the procedure step by step,

一步步地进行手术，

guiding them, training them and teaching them.

指引，培训并教导他们

Within a few months,

几个月以来，

they were able to perform 30 percent more operations

他们进行的手术多了30%，

with less and less complications.

而且并发症也越来越少了

And now Dr. Soraya and her team can perform these operations

现在，Soraya大夫与她的团队

independently, competently and confidently.

能够自信并独立地完成这些手术

And I remember one quote from a mother who said,

我还记得一位母亲曾说过的话：

"This technology gave my daughter her smile."

“这项技术给我的女儿带来了微笑”

For me, this is the real power of this technology.

对于我来说 这项技术的威力就是如此

The beauty is that it breaks boundaries.

美妙的事，它打破了人们之间的间隔

It transcends all technological difficulties.

它可以跨越一切技术困难

It connects people. It democratizes access.

它联系着人们 它使访问民主化

Wi-Fi and mobile technology are growing rapidly,

无线和移动技术的发展十分迅速，

and they should play a role in boosting surgical provision.

而他们应该对手术准确性的提升献出一份力

We've even seen it used in conflict zones where there's considerable risk

这项技术甚至还在一些冲突地区使用，

专业的外科医生去这些地区时会面临很大的危险

in getting specialist surgeons to certain locations.

In a world where there are more mobile devices

在这样一个

移动设备比人类还多的世界中，

than there are human beings,

it truly has a global reach.

它真的可以触及全球

Of course, we've still got a long way

当然，我们还要走一段很长的路

before we can solve the problem of getting surgery to five billion people,

在我们能够解决五百万人民的手术问题之前，

and unfortunately,

令人不幸的是，

some people still don't have access to internet.

有些人仍然没有互联网连接

But things are rapidly moving in the right direction.

但是，世界正在向正确的方向快速发展

The potential for change is there.

发展的潜力很大

My team and I are growing our global footprint,

我和我的团队正在全球化发展，

and we're starting to see the potential of this technology.

而我们才刚刚开始认识到这项技术的潜能

Through digital technology,

通过数字技术，

through simple, everyday devices that we take for granted,

通过我们生活中的普通设备，

through devices of the future,

通过未来的设备，

we can really do miraculous things.

我们真的可以创造奇迹

Thank you.

谢谢大家

(Applause)

（掌声）